Gov.’s SAGE Commission Recognizes Value of Aging Network Approach to Long Term Care as Fiscal Cliff Bears Down

Albany, NY (February 25, 2013) – The Governor’s SAGE (Spending and Government Efficiency) Commission released its final report in February, reaffirming what the Aging Alliance has known all along: New York State would benefit from making greater use of the type of programs and delivery mechanisms employed by the New York State Office for the Aging.

In the spring of 2011, the Aging Alliance – a group of diverse social service agencies that serve New York state's oldest and most vulnerable residents and promote expanded options for aging in place in the community - testified and submitted a proposal to the SAGE Commission urging it to maintain the independence of the New York State Office for the Aging (NYSOFA).

The Aging Alliance also advocated for expanding NYSOFA’s community-based program model with two goals in mind: retaining New York’s senior population, which contributes billions to local economies, and reducing Medicaid costs with supportive at home programs.

Gov. Cuomo's SAGE Commission, which did a two-year-long study on streamlining New York State government, agrees with the Aging Alliance members:

“At first blush, the significant overlap of functions and missions between DOH and SOFA (State Office for the Aging) suggest that a merger could improve the efficiency and program effectiveness of these two independent agencies. However, after substantial analysis, the Commission has concluded that the conditions that would make it possible to greatly expand the approach used by SOFA to help a broader range of older New Yorkers and other New Yorkers with physical disabilities avoid institutional care do not yet exist. Accordingly, the Commission believes that a better course of action is for the State to closely coordinate the two agencies’ policy objectives and consider a full integration if, and only if, the conditions are in place to ensure that the SOFA approach spreads to DOH’s programs for older New Yorkers who are Medicaid eligible, rather than having DOH’s “medical model” and cost structure spread to SOFA’s efficient and popular programs.”

The report singled out programs like Expanded In home Services for the Elderly program, Community Services for the Elderly program and Supplemental Nutrition Assistance Program (aka Wellness in Nutrition) as cost effective alternatives to institutional nursing home care, and said the Department of Health would benefit greatly by adopting the New York State Office for the Aging’s approach to long term care, just as the Fiscal Cliff comes bearing down putting the New York State Office for the Aging's programs at risk.

“The SAGE Commission’s report is solid recognition of the value of the community based non-medical model of long term care used by New York State Office for the Aging funded programs,” said Laura Cameron, Executive Director of the New York State Association of Area Agencies on Aging, in Albany. “An integral part of the system is the NY Connects program, which links individuals of all ages needing long term services and supports with information so that they can make sound choices. The Fiscal Cliff puts them all at risk. New York State Office for the Aging programs are funded using a combination of state, federal and county funding," Cameron said.

"Providing crucial community-based services and programs helps New Yorkers stay in their homes as they age while also saving the state money by keeping them out of expensive nursing homes. Only a stand-alone Office for the Aging can accomplish this for older New Yorkers and caregivers,” said Beth Finkel, State Director for AARP in New York. “The State Office for the Aging must be an office focused on all the needs of New Yorkers as they age. From health care to economic security to age discrimination and exploitation, the issues confronting aging New Yorkers are enormous. These issues can only be successfully tackled by an office dedicated and focused on them so that all New Yorkers can live, work, and grow older in the Empire State with security and peace-of-mind."

"The public's role in helping to maintain, if not enhance, an older adult's quality of life is contingent on an expansive pool of informal and formal services and supports,” according to Carin Tinney, Policy Analyst at United Neighborhood Houses, in New York City. “Like the SAGE commission, we believe the formal supports and services cannot all be delivered, measured, or monitored in the same way. We are encouraged that the SAGE commission recommended the continued existence of the State Office for the Aging and subsequently recognize the importance of the programs offered through it.”

“The Council of Senior Centers and Services commends Governor Andrew Cuomo and the SAGE Commission for recognizing the value of community-based aging services to the lives of thousands of older New Yorkers in every corner of the state,” said Igal Jellinek, Executive Director, Council of Senior Centers and Services of New York City. “A core value of these services has always been to provide person centered services that allow older adults to age in place with dignity in their homes and communities. This prevents many from going on to Medicaid.”

Investing in community based non-medical model

The Aging Network overall was pleased that the core programs were maintained in the Governor’s 2013-14 budget proposal. At the same time, the overall 60+ population has increased by almost 15% since 2000, so technically funding for the aging network isn’t flat, it’s not keeping pace with the burgeoning senior population. An additional $12.3 million for core services in the 2013-14 Executive Budget would help keep pace with increases reported by the 2010 U.S. Census. It would also shore up the New York State Office for the Aging’s non-medical model for providing programs and services that help older New Yorkers maintain their independence.

“Additional support for community based social support services will also clearly serve New York’s short and long range goals of bending the health care cost curve,” according to Ronald Soloway UJA-Federation of New York, Managing Director of Government and External Affairs, inNew York City.

“It’s critical that the segment of elderly New Yorkers who aren’t eligible for Medicaid, but are still struggling financially, receive supportive services. Services also support family caregivers who already provide $32 billion in care that the state doesn’t have to fund,” said Igal Jellinek, Executive Director, Council of Senior Centers and Services of New York City. “With the growth of the elderly population, demand for services is growing. Clearly, additional funding is needed to meet the need.”

The SAGE report sums up the Cuomo Administration’s support for NYSOFA’s long term services and supports:

“…there is a significant overlap between DOH’s goals in the area of long-term care and that of New York State Office for Aging, namely, to provide support services to older adults that enable them to live independently rather than being placed in expensive and unwanted institutional care. The Cuomo Administration’s policy goals for long-term care include making much greater use of exactly the type of programs and delivery mechanisms that New York State Office for the Aging employs and that Department of Health uses to the extent possible within federal Medicaid regulations. These programs represent a cost effective and much desired alternative to institutional care.”

The Aging Alliance organizations look forward to working with the Cuomo Administration to ensure that all older New Yorkers have the opportunity to grow old in the community, meeting the promise of the Olmstead decision, a 1999 Supreme Court Decision that requires states to administer services, programs, and activities "in the most integrated setting."